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母乳喂养与儿童期后期哮喘发作风险降低有关。

Breastfeeding is associated with a decreased risk of childhood asthma exacerbations later in life.

作者信息

Ahmadizar Fariba, Vijverberg Susanne J H, Arets Hubertus G M, de Boer Anthonius, Garssen Johan, Kraneveld Aletta D, Maitland-van der Zee Anke H

机构信息

Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands.

Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.

出版信息

Pediatr Allergy Immunol. 2017 Nov;28(7):649-654. doi: 10.1111/pai.12760. Epub 2017 Sep 6.

Abstract

BACKGROUND

Breastfeeding has been suggested to influence the risk of asthma and asthma severity in children. However, the conclusions from epidemiologic studies are inconsistent.

METHODS

We used data from 960 children (aged 4-12 years) using regular asthma medication who participated in the PACMAN study. Breastfeeding exposure was based on questionnaire data and stratified into (i) ever vs never, and (ii) ≥6 vs <6 months duration of breastfeeding. Asthma severity was based on the occurrence of asthma exacerbations in the preceding year and/or poorly controlled asthma symptoms during the last week of study visit. Odds ratios (ORs) were derived from univariate and multivariable logistic regression analyses.

RESULTS

Breastfeeding was associated with a decreased risk of asthma exacerbations; adjusted (adj.) OR: 0.55 (95% confidence interval [CI]: 0.35-0.87). After stratification for duration of breastfeeding, the adj. ORs were 0.48 (95% CI: 0.27-0.84) for duration <6 months and 0.71 (95% CI: 0.43-1.20) for duration ≥6 months breastfeeding. When we stratified the analysis by family history of asthma, the association between breastfeeding and asthma exacerbations was strong and statistically significant only in children with a positive family history of asthma; adj. OR: 0.34 (95% CI: 0.18-0.66). There was no association between breastfeeding and risk of poor asthma control; adj. OR: 1.04 (95% CI: 0.76-1.41).

CONCLUSION

In a pediatric population with asthma, children who had been breastfed had a statistically significantly lower risk of asthma exacerbations later in life compared to asthmatic children who had not been breastfed.

摘要

背景

有研究表明母乳喂养会影响儿童患哮喘的风险及哮喘的严重程度。然而,流行病学研究的结论并不一致。

方法

我们使用了参与PACMAN研究的960名4至12岁正在使用常规哮喘药物治疗的儿童的数据。母乳喂养情况基于问卷调查数据,并分为:(i)曾经母乳喂养与从未母乳喂养;(ii)母乳喂养时长≥6个月与<6个月。哮喘严重程度基于前一年哮喘发作情况和/或研究访视最后一周哮喘症状控制不佳的情况。比值比(OR)来自单变量和多变量逻辑回归分析。

结果

母乳喂养与哮喘发作风险降低相关;调整后(adj.)OR:0.55(95%置信区间[CI]:0.35 - 0.87)。按母乳喂养时长分层后,母乳喂养时长<6个月的调整后OR为0.48(95%CI:0.27 - 0.84),母乳喂养时长≥6个月的调整后OR为0.71(95%CI:0.43 - 1.20)。当我们按哮喘家族史分层分析时,母乳喂养与哮喘发作之间的关联仅在有哮喘家族史阳性的儿童中较强且具有统计学意义;调整后OR:0.34(95%CI:0.18 - 0.66)。母乳喂养与哮喘控制不佳的风险之间无关联;调整后OR:1.04(95%CI:0.76 - 1.41)。

结论

在患有哮喘的儿科人群中,与未进行母乳喂养的哮喘儿童相比,曾进行母乳喂养的儿童在日后生活中哮喘发作的风险在统计学上显著更低。

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